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使用瞬时弹性成像预测射频消融术后肝细胞癌复发

Using transient elastography to predict hepatocellular carcinoma recurrence after radiofrequency ablation.

作者信息

Lee Yu Rim, Park Soo Young, Kim Seung Up, Jang Se Young, Tak Won Young, Kweon Young Oh, Kim Beom Kyung, Park Jun Yong, Kim Do Young, Ahn Sang Hoon, Han Kwang-Hyub, Hur Keun

机构信息

Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea.

Deparment of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

J Gastroenterol Hepatol. 2017 May;32(5):1079-1086. doi: 10.1111/jgh.13644.

Abstract

BACKGROUND AND AIM

Liver stiffness (LS) value determined using transient elastography (TE) can be used to assess the degree of liver fibrosis. The study investigated whether TE can predict the recurrence of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA).

METHODS

This study retrospectively enrolled 228 patients with HCC who received TE and RFA as the first-line treatment for HCC between 2008 and 2015. Cox regression analysis was used to identify independent predictors of HCC recurrence.

RESULTS

The median age of the study population (170 men and 58 women) was 61 years. During the study period, HCC recurrence and mortality developed in 125 (54.8%) and 37 (16.2%) patients after RFA, respectively. Liver cirrhosis, platelet count, multiple tumors, and LS value were the independent predictors of HCC recurrence. When the study population was stratified into early (< 12 months) and late (≥ 12 months) recurrence groups, LS value was an independent predictor of late recurrence, along with liver cirrhosis and spleen diameter. The risk of late recurrence was higher in patients with LS values of ≥ 13 kPa than in those with LS values of < 13 kPa (adjusted hazard ratio [HR] = 4.507, 95% confidence interval [CI] 2.131-7.724, P < 0.001). Recurrence was the only predictor of overall survival (HR = 18.583, 95% CI 2.424-142.486, P = 0.005).

CONCLUSIONS

Findings of this study suggest that LS measurement using TE can be a useful predictor of HCC recurrence after RFA.

摘要

背景与目的

使用瞬时弹性成像(TE)测定的肝脏硬度(LS)值可用于评估肝纤维化程度。本研究调查了TE能否预测射频消融(RFA)后肝细胞癌(HCC)的复发。

方法

本研究回顾性纳入了2008年至2015年间接受TE和RFA作为HCC一线治疗的228例HCC患者。采用Cox回归分析确定HCC复发的独立预测因素。

结果

研究人群(170例男性和58例女性)的中位年龄为61岁。在研究期间,RFA后分别有125例(54.8%)和37例(16.2%)患者发生HCC复发和死亡。肝硬化、血小板计数、肿瘤数量和LS值是HCC复发的独立预测因素。当将研究人群分为早期(<12个月)和晚期(≥12个月)复发组时,LS值与肝硬化和脾直径一起是晚期复发的独立预测因素。LS值≥13 kPa的患者晚期复发风险高于LS值<13 kPa的患者(调整后风险比[HR]=4.507,95%置信区间[CI] 2.131 - 7.724,P<0.001)。复发是总生存的唯一预测因素(HR=18.583,95%CI 2.424 - 142.486,P=0.005)。

结论

本研究结果表明,使用TE测量LS可作为RFA后HCC复发的有用预测指标。

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